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1.
Chinese Critical Care Medicine ; (12): 1057-1062, 2021.
Article in Chinese | WPRIM | ID: wpr-909452

ABSTRACT

Objective:To explore the evaluation value of sequential organ failure assessment (SOFA) score at different time points in the prognosis of patients with severe pneumonia combined with acute respiratory distress syndrome (ARDS).Methods:A retrospective cohort study method was conducted, including patients with severe pneumonia and ARDS admitted to the emergency intensive care unit (ICU) of General Hospital of Ningxia Medical University from January 2015 to December 2019. General clinical data such as gender, age, and the SOFA scores at 1, 2, 3, and 7 days after admission were recorded. According to the diagnostic test, the prognostic evaluation value of SOFA score in patients with severe pneumonia combined with ARDS at different time points and different ages was analyzed.Results:A total of 88 cases were included in this study, eventually, 42 cases were survived and 46 cases died, the mortality was 52.27%. The age of the death group was significantly older than the survival group (years old: 60.67±14.66 vs. 51.91±15.97), the SOFA score at each time point were significantly higher than those in the survival group (9.83±3.50 vs. 7.54±2.67, 9.98±3.75 vs. 7.48±2.92, 10.84±4.14 vs. 7.23±2.94, 11.71±4.03 vs. 6.51±3.22, respectively at 1, 2, 3, 7 days after admission, all P < 0.01). The receiver operator characteristic curve (ROC curve) showed that the SOFA score at 1, 2, 3, and 7 days after admission had a certain predictive value for the prognosis of patients with severe pneumonia combined with ARDS (all P < 0.01), and with the prolong of ICU stay, the area under ROC curve (AUC) of SOFA score had gradually increased. On the 7th day after admission, the SOFA score had the highest sensitivity in predicting severe pneumonia combined with ARDS patients, which was 92.86%, and the specificity was the highest on the 3rd day after admission, which was 88.10%. The AUC in day 7 was significantly higher than day 2 (0.85 vs. 0.72) , there was no statistically significant difference of AUC at other time points. After stratifying by age, the diagnostic of sensitivity, specificity, accuracy, and AUC of SOFA score for the prognosis had gradually increased, and the predictive value was better. However, only on day 3 after admission, the AUC of SOFA score was significantly higher than day 1 (0.80 vs. 0.77, P < 0.05), and there was no significant difference in AUC at other time points. In patients older than 60 years old, the AUC of the SOFA score predicting the prognosis of patients was relatively small on day 1 and day 2 (0.67, 0.68, respectively), the ability was poor. There was no statistically significant difference in the AUC of SOFA scores at each time point in evaluating the prognosis of patients. The trends over time of patients at different ages and time points showed that regardless of age, the SOFA scores of the patients in the death group showed an upward trend, while showed a downward trend in the survival group, the difference reached the largest on the 7th day after admission, and the death group was significantly higher than the survival group (age < 60 years old: 12.50 vs. 6.69; age≥60 years old: 11.58 vs. 6.21). Conclusion:The initial SOFA score has a certain value in the evaluation of prognosis of severe pneumonia patients combined with ARDS, but the effect is poor for elderly patients.

2.
Article in Chinese | WPRIM | ID: wpr-907135

ABSTRACT

ObjectiveTo provides suggestions to improve the mental health of the medical staff by investigation and effect analysis of mental health status of the medical staff in the public medical institutions in Shanghai. MethodsTo conducted a survey of medical staff in public medical institutions including tertiary general hospitals and tertiary specialized hospitals in Shanghai, using random stratified sampling method. The stratified standard includes hospital classification, title, and practice type. ResultsTotally 3 437 valid questionnaires were collected. Depression, anxiety and compulsion in medical staff were significantly higher than that in the general population. The top three factors that make medical staff anxious were examination, professional promotion, and academic research. The top three stressors were heavy workload, unstable working hours, and promotion pressure. Among the ways to relieve the pressure, the top three were taking a tour, talking with family or friends, and participating in recreational activities. Comparing with female medical staff, male medical staff had a lower level of resilience. ConclusionGovernment should speed up to establish the scientific performance appraisal and salary distribution system, and to guide the society to form a good atmosphere in caring for medical staff. Hospitals should promote the construction of health hospitals, and strengthen the construction of health archives. Individuals should have a healthy lifestyle and actively participate in physical examination and training that can improve mental health.

3.
Article in Chinese | WPRIM | ID: wpr-907112

ABSTRACT

ObjectiveTo provides suggestions to improve the mental health of the medical staff by investigation and effect analysis of mental health status of the medical staff in the public medical institutions in Shanghai. MethodsTo conducted a survey of medical staff in public medical institutions including tertiary general hospitals and tertiary specialized hospitals in Shanghai, using random stratified sampling method. The stratified standard includes hospital classification, title, and practice type. ResultsTotally 3 437 valid questionnaires were collected. Depression, anxiety and compulsion in medical staff were significantly higher than that in the general population. The top three factors that make medical staff anxious were examination, professional promotion, and academic research. The top three stressors were heavy workload, unstable working hours, and promotion pressure. Among the ways to relieve the pressure, the top three were taking a tour, talking with family or friends, and participating in recreational activities. Comparing with female medical staff, male medical staff had a lower level of resilience. ConclusionGovernment should speed up to establish the scientific performance appraisal and salary distribution system, and to guide the society to form a good atmosphere in caring for medical staff. Hospitals should promote the construction of health hospitals, and strengthen the construction of health archives. Individuals should have a healthy lifestyle and actively participate in physical examination and training that can improve mental health.

4.
Acta Pharmaceutica Sinica ; (12): 3224-3232, 2021.
Article in Chinese | WPRIM | ID: wpr-906849

ABSTRACT

In this study, exosomes were extracted from human malignant melanoma cell A375. Folic acid (FA) receptor was used as target and triptolide (TPL) was used as model drug to prepare exosome targeted drug delivery system, FA-Exo/TPL. The physicochemical properties and antitumor effect were evaluated in vivo and in vitro. Gradient centrifugation method was applied to collect exosomes. Then, exosome was modified with FA for loading TPL. The particle sizes of the FA-Exo/TPL were about 100 nm with a double-layer membrane structure like a tray. It is characteristic of high encapsulation efficiency and drug loading. In vitro experiments showed that FA-Exo/TPL could be effectively uptaken by A375 cells, thus significantly inhibiting proliferation and promoting apoptosis the cells. In vivo experiment results showed that FA-Exo/TPL could effectively inhibit the growth of tumor tissue, prolong the model mice life cycle, and significantly reduce the systemic toxicity of the free drug, playing a synergistic and toxic role. Animal welfare and experimental procedures follow the regulations of the Animal Ethics Committee of Fudan University Shanghai Cancer Center. This study provides a new strategies and methods for the preparation of TPL against malignant melanoma.

5.
Acta Pharmaceutica Sinica ; (12): 3421-3430, 2021.
Article in Chinese | WPRIM | ID: wpr-906816

ABSTRACT

Photodynamic therapy (PDT) is a therapeutic strategy by which photosensitizers are excited by specific light irradiation to produce singlet oxygen for killing the surrounding cells. The advantages of PDT include weak invasion, slight side effect, and low resistance. The advantages of nanoscale drug delivery systems (DDS) include tumor-targeting, sustained release, and environmental-sensitivity. The combination of PDT and nanoscale DDS would likely lead to tumor targeting of photosensitizers and enhance their antitumor effectiveness. This review discusses the mechanism of PDT, photosensitizer-loaded nanoscale formulations, the combination of PDT and other antitumor therapies, and summarizes the applications and prospects of anti-tumor nanoscale DDS based on PDT. This review is a useful reference for its clinical application.

6.
Article in Chinese | WPRIM | ID: wpr-906113

ABSTRACT

Objective:To investigate the effect of Ziziphi Spinosae Semen (ZSS) and Albiziae Flos (AF) on behavior and endoplasmic reticulum stress endoplasmic reticulum stress protein kinase R-like endoplasmic reticulum kinase (PERK)/activated transcription factor 4 (ATF4)/CCAAT enhancer binding protein (CHOP) pathway in depression model rats, and to explore its antidepressant mechanism. Method:The male SD rats were divided into normal group, model group, ZSS-AF high dose, middle dose and low dose groups (16, 8, 4 g·kg<sup>-1</sup>) and Venlafaxine group (0.008 g·kg<sup>-1</sup>), <italic>n</italic>=15 in each group. Except the normal group, the depression model was established in the rats of other 5 groups by the method of chronic unpredictable mild stress (CUMS) combined with isolated feeding. The normal group and model group were given with distilled water by gavage when modeling, while other groups received corresponding drug by intragastric administration for 21 days. Behavior changes of rats in each group were observed by the open field test and sugar water consumption test on 1<sup>th </sup>and 21<sup>th</sup>day of the experiment. The protein expressions of PERK, CHOP, B-cell lymphoma-2 associated X protein (Bax) and cysteine-containing aspartate-specific proteases-3(Caspase-3) were detected by Western blot(WB), the ultrastructural changes of the hippocampus were observed by transmission electron microscope, the apoptosis of hippocampal neurons was observed by terminal-deoxynucleoitidyl transferase mediated nick end labeling (TUNEL) method. Result:Compared with the normal group, the scores of open field test and sugar water consumption rate in model group rats decreased (<italic>P</italic><0.01). Compared with the model group, the scores of open field test and water consumption rate increased (<italic>P</italic><0.01) in ZSS-AF groups and Venlafaxine group. Transmission electron microscope showed that the changes of neuronal damage in hippocampal were revealed in the model group, whereas those neuronal damages were relieved in ZSS-AF groups and Venlafaxine group. TUNEL method showed that the number of apoptotic neurons in hippocampal increased in the model group (<italic>P</italic><0.01), but decreased in ZSS-AFgroups and Venlafaxine group (<italic>P</italic><0.01). WB results showed that as compared with the normal group, protein expressions of PERK, CHOP, Bax and Caspase-3 were up-regulated significantly in the model group (<italic>P</italic><0.01), whereas those were down-regulated in ZSS-AF groups and Venlafaxine group (<italic>P</italic><0.05, <italic>P</italic><0.01). Conclusion:The antidepressant effect of ZSS-AF herbal pair may be correlated with the regulation of endoplasmic reticulum stress PERK/ATF4/-CHOP pathway.

7.
Article in Chinese | WPRIM | ID: wpr-905832

ABSTRACT

Objective:To confirm the protective effect of Xiangsha Yuyang decoction on acetic acid-induced gastric ulcer model rats and explore its mechanism, so as to provide experimental basis for clinical drug use. Method:The 60 SPF Wistar rats were randomly divided into 6 groups: group, model group, high, middle and low dose groups of Xiangsha Yuyang decoction and omeprazole control group. The rat model of gastric ulcer was induced by acetic acid. The rats in the high, middle and low dose groups of Xiangsha Yuyang decoction were intragastrically administered at the dose of 28,14,7 g·kg<sup>-1</sup>, and with omeprazole at the dose of 4.17 g·kg<sup>-1</sup>in normal saline, respectively. The rats in the blank group and model group were intragastrically infused with the same volume of normal saline once a day. After 14 days of continuous treatment, the rats were killed, the blood was collected, the area and inhibition rate of gastric ulcer were measured and calculated, the histopathological sections of gastric mucosa were made and the state of gastric mucosal injury was observed, and the changes of gastric mucosal repair factor, gastric tissue related protein, oxidative stress factor and inflammatory factor in serum were detected by enzyme-linked immunosorbent assay(ELISA). Detected the expression of p62 Kelch-like epichlorohydrin-related protein 1 (Keap1), nuclear transcription factor E2 related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) signal pathway-related proteins in gastric mucosa by Western blot. Result:Compared with control group, the gastric mucosa of the model group showed obvious pathological changes and a large number of leukocytes infiltrated. In model group, the ulcer area was significantly increased(<italic>P</italic><0.01), the contents of mucin mucoprotein 5AC (MUC5AC), epidermal growth factor (EGF), superoxide dismutase (SOD) and increased prostaglandin E<sub>2</sub> (PGE<sub>2</sub>) were significantly decreased(<italic>P</italic><0.01), the gastrin (GAS), 8-hydroxydeoxyguanosine (8-OHdG), malondialdehyde (MDA), tumor necrosis factor-<italic>α</italic> (TNF-<italic>α</italic>), cyclooxygenase-2 (COX-2) were significantly increased. The expression of HO-1 and Nrf2 protein decreased significantly(<italic>P</italic><0.01), the content of Keap1 increased significantly (<italic>P</italic><0.05), and the expression of p62 protein decreased. Compared with model group, the hierarchical structure of cells in Xiangsha Yuyang decoction high dose group and omeprazole group were clearer and regular, middle and low dose groups could also repair gastric mucosa to a certain extent. The high and middle dose groups of Xiangsha Yuyang decoction could significantly reduce the gastric ulcer area of acetic acid-induced gastric ulcer rat model (<italic>P</italic><0.01) and increase the ulcer inhibition rate. It can effectively promote the expression of MUC5AC and EGF in gastric mucosa, decrease the level of GAS(<italic>P</italic><0.05,<italic>P</italic><0.01), decrease the level of 8-OHdG and MDA, increase the activity of SOD(<italic>P</italic><0.01), decrease the expression level of TNF-<italic>α</italic> and COX-2, increase the content of PGE<sub>2</sub>, and significantly increase the amount of Nrf2 and HO-1 protein in gastric mucosa(<italic>P</italic><0.01). The high dose group of Xiangsha Yuyang decoction could decrease the protein expression of Keap1(<italic>P</italic><0.05) and increase the expression of p62 protein. Conclusion:Xiangsha Yuyang decoction is effective in the treatment of acetic acid-induced gastric ulcer model rats, which can effectively reduce the ulcer area, increase the ulcer inhibition rate and protect the ulcer tissue. Its mechanism may be related to activating p62/Keap1/Nrf2 signal pathway and regulating the expression of related genes so as to improve inflammatory response and regulate oxidative stress response.

8.
Journal of Clinical Hepatology ; (12): 2435-2438, 2021.
Article in Chinese | WPRIM | ID: wpr-904965

ABSTRACT

Liver cirrhosis is the end stage of various chronic liver diseases, and portal hypertension is a main complication of liver cirrhosis. In this pathological state, spontaneous portosystemic shunt (SPSS), as the collateral circulation of the portal venous system, has not attracted enough attention in terms of occurrence mechanism and clinical value. The analysis shows that although SPSS is a natural shunt channel, further studies are still needed to clarify whether it can be used as a decompression method for portal hypertension, and a deeper understanding of SPSS will provide important guiding significance for the diagnosis and treatment of portal hypertension.

9.
Journal of Clinical Hepatology ; (12): 2357-2363, 2021.
Article in Chinese | WPRIM | ID: wpr-904948

ABSTRACT

Objective To investigate the association between thyroxine level and nonalcoholic fatty liver disease (NAFLD). Methods A retrospective analysis was performed for 3289 subjects who underwent physical examination in PLA Rocket Force Characteristic Medical Center from July 2015 to April 2019, and according to medical history and thyroid function, they were divided into subclinical hypothyroidism group with 210 subjects and normal thyroid function group with 3079 subjects. According to the results of abdominal color Doppler ultrasound, the normal thyroid function group was divided into NAFLD group with 516 subjects and non-NAFLD group with 2563 subjects; according to body mass index (BMI), the normal thyroid function group was divided into non-obese group (BMI 0.05); after stratification based on age and body type, in the obese-young and middle-aged subgroup, male sex, low free thyroxine, fasting blood glucose, and triglyceride were independent risk factors for NAFLD (odds ratio=4.729, 0.067, 1.814, and 1.717, P =0.003, 0.010, 0.011, and 0.014). The cut-off values of free thyroxine, fasting blood glucose, and triglyceride were 1.123 ng/dL, 5.15 mmol/L, and 1.02 mmol/L, respectively, in predicting NAFLD, and the area under the ROC curve was 0.832 for combined prediction. Conclusion There is a high prevalence rate of NAFLD in the population with subclinical hypothyroidism, and when thyroid function is within the normal range, low free thyroxine is associated with the onset of NAFLD in the young and middle-aged obese people.

10.
Journal of Clinical Hepatology ; (12): 2435-2438, 2021.
Article in Chinese | WPRIM | ID: wpr-904915

ABSTRACT

Liver cirrhosis is the end stage of various chronic liver diseases, and portal hypertension is a main complication of liver cirrhosis. In this pathological state, spontaneous portosystemic shunt (SPSS), as the collateral circulation of the portal venous system, has not attracted enough attention in terms of occurrence mechanism and clinical value. The analysis shows that although SPSS is a natural shunt channel, further studies are still needed to clarify whether it can be used as a decompression method for portal hypertension, and a deeper understanding of SPSS will provide important guiding significance for the diagnosis and treatment of portal hypertension.

11.
Journal of Clinical Hepatology ; (12): 2357-2363, 2021.
Article in Chinese | WPRIM | ID: wpr-904898

ABSTRACT

Objective To investigate the association between thyroxine level and nonalcoholic fatty liver disease (NAFLD). Methods A retrospective analysis was performed for 3289 subjects who underwent physical examination in PLA Rocket Force Characteristic Medical Center from July 2015 to April 2019, and according to medical history and thyroid function, they were divided into subclinical hypothyroidism group with 210 subjects and normal thyroid function group with 3079 subjects. According to the results of abdominal color Doppler ultrasound, the normal thyroid function group was divided into NAFLD group with 516 subjects and non-NAFLD group with 2563 subjects; according to body mass index (BMI), the normal thyroid function group was divided into non-obese group (BMI 0.05); after stratification based on age and body type, in the obese-young and middle-aged subgroup, male sex, low free thyroxine, fasting blood glucose, and triglyceride were independent risk factors for NAFLD (odds ratio=4.729, 0.067, 1.814, and 1.717, P =0.003, 0.010, 0.011, and 0.014). The cut-off values of free thyroxine, fasting blood glucose, and triglyceride were 1.123 ng/dL, 5.15 mmol/L, and 1.02 mmol/L, respectively, in predicting NAFLD, and the area under the ROC curve was 0.832 for combined prediction. Conclusion There is a high prevalence rate of NAFLD in the population with subclinical hypothyroidism, and when thyroid function is within the normal range, low free thyroxine is associated with the onset of NAFLD in the young and middle-aged obese people.

12.
China Occupational Medicine ; (6): 402-406, 2021.
Article in Chinese | WPRIM | ID: wpr-923207

ABSTRACT

OBJECTIVE: To analyze the utilization of hospital service and its related influencing factors among patients with occupational pneumoconiosis. METHODS: A total of 178 patients with occupational pneumoconiosis were selected as the study subjects using the convenience sampling method. The utilization of hospital service and health-related quality of life of patients with pneumoconiosis and its complications were investigated using the Questionnaire on Pneumoconiosis Patients′ Medical Consultation Behavior and its Influencing Factors and the European Quality of Life Inventory.RESULTS: The one-year hospitalization rate of patients with pneumoconiosis was 57.3%(102/178), and 88.2% of the patients were hospitalized once a year. The median number of hospitalization time in a year was 20.0 days. Visual health scale(VAS) score was(58±15) points. The multiple logistic regression analysis results showed that the utilization of hospital service among patients with employment injury insurance and fund reimbursement provided by the local governmentwere higher than those without employment injury insurancea nd without fund reimbursement provided by the local government(all P<0.05). The utilization of hospital service of patients with problems in usual activities and those unable to perform usual activities were higher than those without any problems(P<0.05). The utilization hospital service of patients with VAS scores <60 was higher than those with VAS scores of 60-<75(P<0.05). CONCLUSION: The patients with pneumoconiosis have a relatively overall high level of utilization of hospital service. The employment injury insurance, fund reimbursement provided by the local government, VAS score, and status of physical health are important influencing factors of utilization of hospital service.

13.
China Occupational Medicine ; (6): 266-271, 2021.
Article in Chinese | WPRIM | ID: wpr-923161

ABSTRACT

OBJECTIVE: To explore the current situation of job burnout, sleep quality and working ability and the association among them in oil workers. METHODS: A total of 2 086 oil workers from six oil field companies in a city of Xinjiang Uygur Autonomous Region were selected as the study subjects using a typical sampling method. The job burnout level, sleep quality and working ability were measured respectively by the Maslach Burnout Inventory-General Survey, Pittsburgh Sleep Quality Index and Work Ability Index Questionnaire. RESULTS: The average score of job burnout in the study subjects was(48.6±11.0), the median and the 25 th, 75 th percentile of sleep quality and working ability scores were 6.0(5.0, 8.0) and 39.0(36.0, 42.0) respectively. There was a negative correlation between job burnout and working ability, or sleep quality and working ability [spearman correlation coefficient(r_S) were-0.28 and-0.21, all P<0.01]. There was a positive correlation between job burnout and sleep quality(r_S=0.19, P<0.01). The structural equation model results showed that both job burnout and sleep quality had a direct effect on working ability of oil workers [normalized path coefficient(β) were-0.29 and-0.27, respectively, all P<0.01]. Job burnout could indirectly affect working ability through reducing sleep quality(β=-0.12, P<0.01). CONCLUSION: The higher the degree of job burnout and the poorer the sleep quality, the lower their working ability in oil workers. Oil workers with a higher degree of job burnout can lead to poorer sleep quality, which in turn leads to a decline in their working ability.

14.
Neuroscience Bulletin ; (6): 1397-1411, 2021.
Article in English | WPRIM | ID: wpr-922649

ABSTRACT

Exposure to chronic hypoxia is considered to be a risk factor for deficits in brain function in adults, but the underlying mechanisms remain largely unknown. Since active myelinogenesis persists in the adult central nervous system, here we aimed to investigate the impact of chronic hypoxia on myelination and the related functional consequences in adult mice. Using a transgenic approach to label newly-generated myelin sheaths (NG2-CreER


Subject(s)
Animals , Clemastine , Hypoxia/complications , Mice , Mice, Inbred C57BL , Mice, Transgenic , Myelin Sheath , Oligodendroglia
15.
Article in English | WPRIM | ID: wpr-922401

ABSTRACT

OBJECTIVES@#To study the association of β2-drenergic receptor (@*METHODS@#A total of 143 children with asthma who attended the hospital from October 2016 to October 2020 were enrolled as the asthma group, among whom 61 children had mild symptoms (mild group) and 82 children had moderate-to-severe symptoms (moderate-to-severe group). A total of 137 healthy children were enrolled as the control group. Peripheral venous blood samples were collected from the two groups. The SNaPshot SNP technique was used to analyze the SNP and haplotypes of the @*RESULTS@#Polymorphisms were observed in the @*CONCLUSIONS@#SNP/haplotype of the


Subject(s)
Asthma/genetics , Case-Control Studies , Child , Genetic Predisposition to Disease , Genotype , Haplotypes , Humans , Polymorphism, Single Nucleotide , Receptors, Adrenergic, beta-2/genetics , Regulatory Sequences, Nucleic Acid
16.
Chinese Acupuncture & Moxibustion ; (12): 1089-1094, 2021.
Article in Chinese | WPRIM | ID: wpr-921015

ABSTRACT

OBJECTIVE@#To compare the clinical therapeutic effect between deep needling at Xiaguan (ST 7) with round sharp needle combined with plum-blossom needle and conventional acupuncture in patients with trigeminal neuralgia (TN) of wind and heat, and explore its mechanism.@*METHODS@#A total of 60 patients with TN of wind and heat were randomized into an observation group (30 cases) and a control group (30 cases). In the observation group, deep needling with round sharp needle was applied at Xiaguan (ST 7), and tapping with plum-blossom needle was applied at Yangbai (GB 14), Quanliao (SI 18), Dicang (ST 4), Sibai (ST 2), etc. of affected side. In the control group, conventional acupuncture was applied at the same acupoints selected in the observation group. The treatment was given once a day, 5 times a week for 4 weeks in the both groups. Before and after treatment, the scores of short-form McGill pain questionnaire (SF-MPQ), TCM syndrome, patient global impression of change (PGIC) and comprehensive symptom were observed, the serum levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), vasoactive intestinal peptide (VIP) and β-endorphin (β-EP) were detected, and the adverse reaction was observed in the both groups.@*RESULTS@#After treatment, the scores of PRI, PPI, VAS, TCM syndrome, PGIC and comprehensive symptom and the serum levels of IL-6, TNF-α and VIP were decreased compared before treatment in the both groups (@*CONCLUSION@#Deep needling at Xiaguan (ST 7) with round sharp needle combined with plum-blossom needle can effectively treat the trigeminal neuralgia of wind and heat and relieve pain, its therapeutic effect is superior to conventional acupuncture. The mechanism may be related to the regulation of serum IL-6, TNF-α, VIP and β-EP.


Subject(s)
Flowers , Hot Temperature , Humans , Prunus domestica , Trigeminal Neuralgia/therapy , Wind
17.
Article in Chinese | WPRIM | ID: wpr-911654

ABSTRACT

Objective:We aimed to evaluate the predictive value of pre-implantation biopsy combined with Lifeport for the short-term prognosis of kidney allograft from donation after citizen death (DCD).Methods:Data from a total of 34 patients who had undergone kidney transplantation in Jinling Hospital from December 2017 to December 2019 were retrospectively analyzed. Histopathological data from pre-implantation biopsy , Lifeport parameters and recipient kidney transplant function at 3 months post-surgery were collected. The performances of histopathological indexes , and Lifeport parameters to predict delayed graft function (DGF) and estimated glomerular filtration rate (eGFR) at 3 months post-surgery were observed evaluated.Results:13 cases of DGF occurred, accounting for 38.2%. Serum creatinine at death and resistance index (RI) at 0.5 h, 1 h, 2 h and 4 h after Lifeport hypothermic machine perfusion (HMP) in the DGF group was significantly higher than that in the non-DGF group. Histologically, the acute tubular injury (ATI) score of the DGF group was higher than that of the non-DGF group, whereas the Remuzzi score was not statistically different between the two groups. The eGFR at 3 months post-transplant was moderately correlated with the RI at 4 h HMP and the Remuzzi score (RI: r=-0.48, P<0.001; Remuzzi score: ρ=-0.42, P=0.01), but no correlated with ATI score of the donor kidney. Although Remuzzi score was not correlated with kidney allograft recovery time (ρ=-0.25, P=0.16), it was inversely correlated with eGFR at 3 months post-transplant (ρ=-0.42, P=0.01). Combined use of Lifeport HMP 4-hour RI and ATI score increased the sensitivity and specificity of predicting DGF to 100% (95% CI: 75.3%-100%) and 90.5% (95% CI: 69.6%-98.8%) respectively. Conclusions:The serum creatinine at death, Lifeport RI, and ATI score of the DGF group were significantly higher than those of the non-DGF group, and the eGFR at 3 months post-transplant was correlated with the Lifeport RI and Remuzzi score. Combined use of ATI score and RI at 4 hours of Lifeport perfusion improved the sensitivity and specificity of predicting DGF .

18.
Article in Chinese | WPRIM | ID: wpr-911185

ABSTRACT

Objective:To identify the risk factors for postoperative central nervous system complications (CNSC) developed in pediatric patients undergoing cardiac surgery under cardiopulmonary bypass (CPB) through determining regional cerebral oxygen saturation (rSO 2C) by near-infrared spectroscopy. Methods:A total of 60 pediatric patients with congenital heart disease undergoing elective orthodontic correction surgery under CPB, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, of both sexes, aged 6-36 months, weighing 5-19 kg, in our hospital from July 2019 to January 2020 were collected.Intraoperative bilateral rSO 2C was monitored continuously by near-infrared spectroscopy.Blood samples were taken from the central vein at 10 min after induction of anesthesia, immediately after CPB, at the end of CPB, on admission to ICU, at 4 and 8 h after entering ICU and at 1, 2 and 3 days after surgery (T 0-8) for determination of the concentrations of serum S100β protein and neuron specific enolase (NSE). At 12 months after surgery, the Pediatric Cerebral Performance Category (PCPC) score was used to evaluate the prognosis of neurological function.The patients were divided into 2 groups according to whether CNSC occurred: CNSC group and non-CNSC group.Multivariate logistic regression analysis was used to identify the risk factors for development of postoperative CNSC in pediatric patients undergoing cardiac surgery under CPB. Results:Two patients were excluded from the study.Eighteen cases developed postoperative CNSC, and the incidence was 31.0%.Compared with group non-CNSC, the minimal rSO 2 was significantly decreased, the maximal difference between pulse oxygen saturation and rSO 2C (da-rSO 2C) was increased, duration of reduction in rSO 2>25% during CPB, duration of rSO 2C<40% during CPB and duration of da-rSO 2C>50% during CPB were prolonged, and concentrations of serum S100β protein and NSE were increased at T 2-T 8 in group CNSC ( P<0.05). The results of logistic regression analysis showed that prolonged duration of reduction in rSO 2C>25% during CPB, prolonged duration of rSO 2C<40% during CPB and prolonged duration of da-rSO 2C>50% during CPB were risk factors for development of postoperative CNSC. Conclusion:Prolonged duration of reduction in rSO 2C>25% during CPB, prolonged duration of rSO 2C<40% during CPB and prolonged duration of da-rSO 2C>50% during CPB are the risk factors for postoperative CNCS developed.

19.
Chinese Journal of Geriatrics ; (12): 1093-1096, 2021.
Article in Chinese | WPRIM | ID: wpr-910970

ABSTRACT

Objective:The purpose of the study was to explore the association between red blood cell volume distribution width(RDW)and in-hospital mortality in elderly patients with acute ST segment elevation myocardial infarction(STEMI).Methods:A total of 429 elderly patients aged ≥65 years diagnosed with acute STEMI were recruited for this study.These patients were divided into 2 groups according to the median RDW: the low RDW group(RDW<13.33%, n=213)and the high RDW group(RDW≥13.33%, n=216). The in-hospital mortality was compared between the groups, and the relationship between RDW and in-hospital mortality in elderly STEMI patients was analyzed.Results:The in-hospital mortality of the high RDW group was significantly higher than that of the low RDW group(12.0% or 26 cases vs.3.3% or 7 cases, P<0.01). After adjusting for differences in age, sex, mean erythrocyte volume, RDW grouping and Killip grade between the two groups, the risk of in-hospital death for patients in the high RDW group was 3.258 times that in the low RDW group( OR=3.258, 95% CI: 1.291-8.222, P<0.05). In addition, aging( OR=1.079, 95% CI: 1.003-1.161, P<0.05)and Killip grade ≥Ⅲ( OR=13.987, 95% CI: 6.136-1.879, P<0.01)were also associated with increased risk of in-hospital death in elderly STEMI patients. Conclusions:RDW is associated with in-hospital mortality in elderly STEMI patients and can predict in-hospital mortality of STMEI in elderly patients.

20.
Article in Chinese | WPRIM | ID: wpr-888133

ABSTRACT

The Solanaceae plants distributed in China belong to 105 species and 35 varietas of 24 genera. Some medicinal plants of Solanaceae are rich in tropane alkaloids(TAs), which have significant pharmacological activities. In this paper, the geographical distribution, chemical components, traditional therapeutic effect, pharmacological activities, and biosynthetic pathways of TAs in Solanaceous plants were summarized. Besides, the phylogeny of medicinal plants belonging to Solanaceae was visualized by network diagram. Fourteen genera of Solanaceae plants in China contain TAs and have medical records. TAs mainly exist in Datura, Anisodus, Atropa, Physochlaina, and Hyoscyamus. The TAs-containing species were mainly concentrated in Southwest China, and the content of TAs was closely related to plant distribution area and altitude. The Solanaceae plants containing TAs mainly have antispasmodic, analgesic, antiasthmatic, and antitussive effects. Modern pharmacological studies have proved the central sedative, pupil dilating, glandular secretion-inhibiting, and anti-asthma activities of TAs. These pharmacological activities provide a reasonable explanation for the traditional therapeutic efficacy of tropane drugs. In this paper, the geographical distribution, chemical components, traditional therapeutic effect, and modern pharmacological activities of TAs-containing species in Solanaceae were analyzed for the first time. Based on these data, the genetic relationship of TAs-containing Solanaceae species was preliminarily discussed, which provided a scientific basis for the basic research on TAs-containing solanaceous species and was of great significance for the development of natural medicinal plant resources containing TAs.


Subject(s)
Biosynthetic Pathways , Phylogeny , Plants, Medicinal , Solanaceae/genetics , Tropanes
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